Neonatal Intensive Care Drug Manual

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Contents
Introduction

CHS21/305

Canberra Health Services

Neonatal Intensive Care Drug Manual

Contents 1

Introduction 6

Template 8

Medications 9

Acetylcysteine for Mucolysis 9

Aciclovir 15

Adenosine 19

Adrenaline (Resuscitation) 21

Adrenaline (Epinephrine) IV infusion 25

Adrenaline (Epinephrine) Inhalation 31

Albumin 4% 34

Albumin 20% 39

Amikacin 44

Amlodipine 49

Amoxycillin 51

Amoxicillin Clavulanate 56

Ampicillin 63

Amphotericin B- Liposomal 67

Aspirin 72

Atropine 75

Azithromycin 78

Caffeine 84

Calcium Gluconate 92

Calcium Oral 100

Calcitriol 106

Captopril 108

Cefalexin 110

Cefotaxime 114

Ceftazidime penthydrate 117

Cephazolin 120

Chloral Hydrate 123

Chloramphenicol (Topical) 127

Clonazepam 131

Clonidine 133

Clotrimazole Cream 139

Co-trimoxazole (sulfamethoxazole-trimethoprim) 141

Cryoprecipitate 145

Curosurf: Poractant alfa 147

Cyclomydril 151

Dexamethasone 154

Dexmedetomidine 163

Diazoxide 173

Digoxin 176

Dobutamine IV Infusion 186

Dopamine IV Infusion 190

Enoxaparin (Clexane) 193

Epoprostenol (also known as Prostacycin or Prostaglandin I2 (PGI2)) 198

Erythromycin 201

Erythropoietin 205

Fentanyl 207

Ferrous Sulfate (Ferro-Liquid) 213

Flecainide 223

Flucloxacillin 227

Fluconazole 232

Fluids- Adjusting the content of bags 234

Flumazenil 240

Folic Acid 241

Frusemide 246

Ganciclovir 252

Gentamicin 256

Glucagon 263

Glycerol (Glycerine) 266

Heparin 270

Heparin CVC Lock 275

Hepatitis B Immunoglobulin 277

Hepatitis B Vaccine 279

Hydralazine 282

Hydrochlorothiazide 284

Hydrocortisone 287

Ibuprofen 294

Imipenem/Cilastatin 302

Immunoglobulin IV (Intragram®P): 305

Indomethacin 313

Infanrix hexa 316

Infloran® 320

Insulin (Actrapid – for hyperglycaemia) 323

Insulin (Actrapid – for hyperkalemia) 330

Isoprenaline 335

Isovue 342

Labetalol 344

Levetiracetam (Keppra) 347

Lignocaine for seizures 354

Lignocaine for local anaesthetic, cardiac arrhythmia 356

Magnesium 359

Meropenem 365

Metoclopramide 369

Metronidazole 371

Miconazole 374

Midazolam 376

Milrinone 381

Morphine IV 388

Morphine Oral 395

Naloxone 400

Neostigmine 405

Noradrenaline 408

Nystatin 411

Octreotide 415

Omeprazole 418

Palivizumab 424

Pancreatic Enzymes/Creon 429

Pancuronium 430

Pantoprazole 436

Paracetamol 440

Penicillin G (Benzyl Penicillin) 445

Pentavite (Multivitamin Prep) 451

Phenobarbitone 453

Phenytoin 458

Phosphate Supplement 464

Piperacillin/Tazobactam 470

Pneumococcal vaccine – Prevenar 13 475

Potassium Chloride 478

Prednisolone 485

Propofol 487

Propranolol 494

Prostaglandin E1(Alprostadil) 503

Prostacyclin PGI2(Epoprostenol) 508

Pyridoxine 510

Ranitidine 512

Recombinant Factor VIIa 520

Resonium A 522

Rotavirus Vaccine 525

Salbutamol 530

Sildenafil 533

Sodium Bicarbonate 539

Sodium Chloride 23.4% (NaCl) 544

Sotalol 549

Spironolactone 553

Sucrose 555

Survanta 559

Suxamethonium Chloride (Scoline) 564

Levothyroxine (Thyroxine) Oral 568

Tobramycin 576

Ursodeoxycholic Acid 583

Valgancyclovir 585

Vancomycin-Continuous 588

Vancomycin-Intermittent 595

Vasopressin 604

Vecuronium 613

Vitamin A (Retinol) 618

Vitamin E (Alpha-Tocopherol) 621

Vitamin K1 624

Zidovudine 628

Zoster Immunoglobulin 633

Introduction

Scope

This guideline applies to all staff working within their scope of practice in the Department of Neonatology, Canberra Health Services (CHS).

Background

The drug guidelines have been developed after thorough review of recent perinatal literature, the Australian Neonatal Medicines Formulary (ANMF) as well as experiences within the CHS Neonatology Unit.

The manual includes up to date versions of ANMF drugs as well as other drug pages not on ANMF. Several ANMF drugs have been modified to suit local practices as well as CHS formulary availability (changes have been highlighted within the page). It is a requirement for staff in scope to follow the drug pages in this manual (located on the CHS Policy and Guidance Documents Register) instead of downloading from the ANMF website.
Some methods of administration may be considered new or novel but should not be avoided for this reason. Recommendations are made on the best available evidence. Should there be any discrepancies, staff should bring these to the attention of the authors. Suggestions for change are welcome. Thank you for your continued efforts in keeping this document up to date with the latest evidence.
Governance

Approval of and changes to the drugs in this manual is through the Drugs and Therapeutic Committee (DTC).

This manual is routinely updated by the Departments of Neonatology and Pharmacy. Each drug is reviewed by consultants and pharmacists in the Department of Neonatology prior to submission to the DTC. As Neomed drugs have already been reviewed by several neonatologists, pharmacists and subject matter experts, they are submitted to DTC without a CHS consultation process.
Entries in this manual should not be annotated or marked – this will only serve to confuse and may lead to mistakes or errors in administration.

Abbreviations

Note that the following abreviations are used throughout this document:

WFI = Water for injection.

D5W = 5% Dextrose Water

D10W = 10% Dextrose Water

NS = 0.9% Normal Saline

AK: Alison Kent

JD: Jacky Dobson

TC: Tejasvi Chaudhari

KOH: Kate O’Hara

MO: Miriam O’Brien

TCo: Tim Cochrane

NS: Nadia Schmidt